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Meningococcal Sepsis Complicated by Symmetrical Peripheral Gangrene: A Case Report

Jessica Ennis1, Ola Ahmed1, Muhammad Khalid2,3

  • 1General Surgery, Connolly Hospital Blanchardstown, Dublin, IRL.

Cureus
|September 3, 2020
PubMed

Insights

Symmetrical peripheral gangrene (SPG), a rare complication of sepsis, involves limb ischemia. Early recognition and treatment with heparinization are key to managing this severe condition.

Area of Science:

  • Critical Care Medicine
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Symmetrical peripheral gangrene (SPG) is a rare but severe complication of sepsis and disseminated intravascular coagulation (DIC).
  • It presents as distal ischemia in multiple extremities without evidence of large vessel obstruction.
  • High mortality and morbidity rates are associated with SPG, yet consensus management guidelines are lacking.

Observation:

  • A case report details a 28-year-old woman with meningococcal septicaemia who developed extensive bilateral upper and lower limb SPG.
  • The patient's presentation highlights the severe distal ischemia characteristic of SPG.

Findings:

  • The case underscores the critical need for early recognition of sepsis and its complications.
  • Prompt withdrawal of vasoconstrictors and timely heparinization in an intensive care setting are identified as crucial management strategies.
  • These interventions appear to be the most common approach in the limited literature available for SPG.

Implications:

  • This case emphasizes the importance of prompt diagnosis and multidisciplinary management for patients with sepsis-induced SPG.
  • Further research and development of clinical guidelines are warranted to improve outcomes for this high-risk condition.
  • Early intervention strategies discussed may reduce morbidity and mortality associated with SPG.
Keywords:
amputationdicmeningococcal sepsissepsissymmetrical peripheral gangrene

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